Characteristics and Causes
Attention disorders may be one of the most prevalent
problems of childhood. Three to five percent of the child population
(roughly 2 million school-aged children) has some type of attention
disorder—or one attention disorder child per classroom. What’s
While professional debate continues on the exact characteristics
of attention disorders, clinical research strongly suggests that
people suffering from inattention fall into two categories—those
who are hyperactive and those who are not. Attention Deficit
Hyperactivity Disorder (ADHD) consists of motor hyperactivity and impulsive behavior,
while Attention Deficit Disorder (ADD) is characterized by inattention,
disorganization and difficulty in completing tasks.
ADHD children behave in an impulsive and aggressive way. They often
seem guiltless, are unpopular and perform poorly in school. They
have little self-control and are very impulsive, noisy, disruptive,
messy, irresponsible and immature for their age. If the image of “Dennis
the Menace” comes to mind, you’ve got the picture.
In contrast, ADD children tend to be anxious, shy, socially withdrawn
and somewhat unpopular. They tend to perform poorly in sports and
in school, and often daydream and stare into space. They forget daily
activities and are sluggish and drowsy. Terms like “space cadet” and “couch
potato” fit well. But they are less aggressive, impulsive and
hyperactive than ADHD children and have fewer relational problems,
While all children on occasion will be impulsive or “hyper,” kids
with attention disorders exhibit these characteristics all the time.
They “misbehave” everywhere—school, church, grandma’s,
the grocery store and home.
Diagnosing attention deficit disorders can be tricky. There is a
big difference between suspecting a child has an attention problem
and knowing for sure that the child has ADHD or ADD. Proper diagnosis
and treatment by a competent professional is important for the long-term
well-being of your child and your family. The following information
is provided to help you determine whether you should seek professional
help or if your child is merely tightly-wound and squirmy. For the
sake of ease, the abbreviation ADD will be used for all types of
attention disorders, unless a specific reference is being made.
Characteristics of ADD
Most experts agree that four characteristics or tendencies identify
attention deficit disorders.
- Inattention and distractibility. An ADD child
has a difficult time focusing on the task at hand and sticking
to it—he usually
ends up daydreaming. He cannot concentrate on schoolwork or anything
that requires sustained attention. Following through on instruction
and completing a task is almost an impossibility, especially if the
instructions involve multiple steps; and he gives the impression
of not listening. But even more frustrating for the parent or teacher
is this child’s ability to pay attention in certain circumstances,
like when watching TV or playing video games. He may also shape up
while at the doctor’s office or one-on-one with an adult.
This adds to the problem. When parents and teachers see the child
attention in one situation, they tend to conclude that he simply
does not try in others, like when asked to do chores or follow
instructions. The heart of understanding attention disorders
is determining how
much of the attentional choosing is conscious, and how much is
biochemically determined. The problem is regulation of focus
- Overarousal or hyperactivity. Some ADD children
are excessively restless, overactive and easily aroused. This affects
movement. It is important to remember that while hyperactivity
used to be the primary description in attention disorders, it
actually occurs in less than 30 percent of children who have ADD.
hyperactivity is used to refer to the entire syndrome of
attention disorders. Other times the term only describes overarousal.
these different uses in mind as you read various books and
articles about ADD.) Hyperactive children have a tough time controlling
body movement, especially when they are required to sit still
for a long time. This ranges from minor fidgeting to perpetual
Some hyperactive children also have restless sleep patterns.
kids are rarely focused—they will move from one thing to the
next with little purpose. While a trip to the grocery store might
be a mild adventure, a stop at the toy store can turn into an absolute
disaster. Emotional variation also comes into play. An ADD child’s
emotions fluctuate quickly, going from one extreme to the other.
Whether they are happy or sad, the child’s feelings are expressed
for everyone to notice. He may become very frustrated over a minor
incident. But chances are he will forget the upsetting event just
as quickly. This can be frustrating to a parent who is still bothered
by the outburst and doesn’t understand why the child is no
longer upset. This leads to the assumption that ADD children lack
a conscience. But that’s untrue—they’ve
just moved on to other thoughts and have put the outburst
- Impulsivity. ADD children appear not to think
before they act and have trouble weighing the consequences of their
just can’t seem to wait—everything has to happen NOW.
In young children, this may result in injury—an ADD child
often literally leaps before he looks. He may jump off the back
of the couch because
it looks like fun, but not have the coordination to land
safely. He may also fight frequently with his friends because of
words and actions. He wants to be in charge socially because
his dominance will prevent him from being bored; but his peers
find his aggressiveness irritating. In school, ADD children
constantly interrupt the teacher, jumping up to answer a question
is even asked. They tend to work impulsively, jotting down
answers without thinking through the problems or thoroughly reading
You can often reason one-on-one with these children, with
them logically analyzing the consequences of their actions. But
put them back in
the real world and they seem overwhelmed, resuming to act
first and think later. ADD children have a lot of trouble following
They may know the rules and even be able to explain them.
But 10 minutes later, when a parent or teacher isn’t looking,
they are “at it” again. Their need for immediate gratification,
coupled with the inability to stop and think, leads to impetuous
non-thinking behavior. And from all appearances, these children
just don’t seem to “get it.” Thus, they are
often labeled willfully disobedient, inconsiderate and oppositional.
deficit disorder is not a problem of knowing what to do,
it is a problem of not doing what the child knows.*
- Difficulty with rewards. ADD children have problems
working toward a long-term goal. They often want brief, repeated
rather than a single, delayed reward. They want what they want
and even with repeated rewards, they do not respond to
incentives as well as other children their age. And once the reward
system is removed, the ADD child is likely to regress. Punishment
to have a limited effect on the child’s behavior. A scolding
will usually work on the child’s behavior for only
a few minutes before the misbehavior continues.
- Difficulty with social skills. Many ADD children
and teens misread social cues.
This can affect the development
of healthy interpersonal
skills, leading to frustration and inappropriate or withdrawn
Causes and sources of ADD
Although ADD continues to be one of the most thoroughly researched
conditions of childhood, its exact causes are still not known. The
neurochemical abnormalities that might underlie this disorder are
difficult to document though research suggests that ADD has a biological
basis. Many ADD children seem to arrive in the world with temperaments
that leave them difficult to manage. Part of this predisposition
may very well be inherited—very often kids are described as “a
chip off the old block.”
But take heart. The symptoms of ADD are not externally created by
parents. A child’s attentional problems do not result from
faulty discipline. While it is true that parental frustration and
negative reactions toward your child can aggravate the problem, guilt,
anger and resentment can hurt a parent’s relationship with
his child and hinder effective treatment. A nurturing home with clear
and consistent structure is crucial to the treatment of ADD children.
And while environmental conditions can play a role, the effects of
changes in diet and other similar things show up more on an individual
basis than in large numbers. There is very little evidence that ADD
arises purely out of social or environmental factors, like dysfunctional
families, vitamin deficiency, excessive amounts of sugar, lead poisoning,
fluorescent lighting or faulty parenting.
Does my child suffer from ADD?
There is no simple test that determines a child has ADD. Diagnosis
is a complicated process that requires the skill of a psychologist,
psychiatrist, pediatrician or pediatric neurologist. A proper diagnosis
orients the child and his parents or caregivers to the nature of
his difficulties by providing information about his strengths and
weaknesses, and any situations that would be particularly troublesome
for him. It should also reveal his academic abilities, enabling him
to get the most out of school.
Perhaps even more important, it is crucial to determine the presence
of other problems—learning disabilities, mood disorder, anxiety
disorder, conduct disorder, poor socialization, disruptive family
relationships—and the evaluation will do this, as well. Treatment
can then be appropriately provided for all of the child’s concerns.
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